Family Medicine / Direct Primary Care / Walk-Ins

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The form will ask for your name, address, contact information, and health history. Near the end, you can view the agreement you will be asked to sign when you first come to the office. Keep in mind that you can terminate the contract at any time and there are no minimum enrollment terms. The contract does not become valid until you sign it at our office. The final enrollment page asks for your credit card information but that page is strictly optional until you have established care at our office. If you have questions or would like someone to contact you about our unique practice, please use our contact page or call us at (601)790-7105.

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